New medical data ...

[annamaria]

(For Forum Member only ... do not promulgate)

Annamaria
= = = =

Stereotactic radiation treatment of vestibular schwannoma: indications, limitations, and outcomes

Oct. 2010

George S. Conley & Barry E. Hirsch
Department of Otolaryngology, Eye and Ear Institute, University of Pittsburgh
Current Opinion in Otolaryngology & Head and Neck Surgery 2010, 18:351–356


Abstract:

Purpose of review: Stereotactic radiation treatment is an increasingly performed procedure for patients with vestibular schwannoma and other benign skull base tumors. During the past 30 years, advancements in stereotactic imaging, radiation delivery techniques, and dose planning have improved overall patient outcomes. The specific role of radiation in current management strategies for vestibular schwannoma continues to evolve as long-term outcome data are analyzed and standardized studies are performed. The recent literature regarding the indications, limitations, and outcomes for stereotactic radiation treatment is reviewed.

Recent findings: Systematic reviews of the Gamma Knife literature demonstrate improved overall outcomes with radiation doses below 13 Gy. Observation of small vestibular schwannomas is recommended over early radiation or microsurgical intervention. Radiation may be used as adjunctive therapy for large tumors and in certain postradiation treatment failures. Stereotactic radiosurgery and fractionated radiotherapy are equally effective treatment modalities.

Summary: Long-term outcome data will ultimately define future indications and limitations for the use of stereotactic radiation with benign skull base lesions. Current evidence supports its use for small to medium sized primary and recurrent vestibular schwannomas with optimal dosing below 13 Gy. It is also recommended for adjunctive therapy, recurrent tumors, in poor surgical candidates, and for those who do not desire observation or surgery.

Link:

http://journals.lww.com/co-otolaryngology/Abstract/2010/10000/Stereotactic_radiation_treatment_of_vestibular.2.aspx

This post was edited to comply with copyright laws. - SPG

[leapyrtwins]

Annamaria -

noticed my neurotologist's name in this article (Battista) along with the radiation oncologist he does GK with (Sweeney).

Thought you might also be interested in this article that Dr. Battista wrote about GK.

http://www.keepingyouwell.com/News/NewsArticle/tabid/191/ItemID/3304/srcmid/71292/Default.aspx

If you want a copy of the article, I'd imagine you could contact the publication it appeared in.

Dr. Battista also wrote a textbook on radiation.  If you or your husband are interested in it let me know and I'll PM you the title.  I believe it can be purchased on Amazon.  I know your husband is very interested in this kind of research.

Best,

Jan

[ppearl214]

As we know, there are many proven AN radio treatment options available to AN'ers (individual AN situations apply, ie: size, precise location of growth, etc) and I'm proud to be walking proof of such (Cyberknife).  As we know, "individual results may vary" as we have also seen those that had radio done and not with the outcomes hoped.  Good to see updated info now being made available and that the ANA is staying on top of this as well (anxious to see what will be presented at next year's symposium in Cinci to also get updates). Thanks for sharing.

Phyl

[annamaria]

What's on this thread (now) is only the abstract. 

Anyone considering Gamma or Fractionalized may want to read this article (if you are analytically inclined and/or you like to do your own research). You would have to pay ($35) and download it ... if you want a more extensive summary of the article than shown above, send me private post.

Annamaria

[rupert]

    I met with Dr.  Hirsch last year.    The findings in this article are what was described to me as the methods he is now following for his patients.

     That being,    Radiation is becoming the treatment of choice for small to medium AN's    and that leaving part of the tumor in order to help
preserve facial nerve function is more common now than total removal.    Following up with radiation.